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Does Medicare cover telehealth?

Just the Essentials...

  • Telehealth services can reduce unnecessary in-office visits for seniors and help them take charge of their health at home.

  • Some telehealth services are covered by Medicare Part B, but only if certain conditions are met.

  • During the COVID-19 pandemic, Medicare telehealth coverage was temporarily expanded.

  • Medicare Advantage plans must also offer the same telehealth coverage as Medicare Part B and may also include additional benefits.

Discover your coverage options for telehealth and more by calling our hotline. Dial (800) 950-0608 to speak with a licensed Medicare insurance agent.

Am I covered for telehealth appointments under Medicare?

As communications technology continues to evolve, it’s changing the way that people receive medical treatment.

Telehealth, or virtual healthcare, is quickly becoming a useful tool for both patients and medical professionals. Telehealth visits are like a traditional doctor’s appointment or checkup, but instead of taking place in an office or hospital setting, they are conducted online via video and audio communication devices.

Telehealth appointments are especially helpful for seniors with limited mobility, because a telehealth visit doesn’t require leaving the house or worrying about transportation. Telehealth appointments can also encourage more frequent, open communication between doctor and patient.

This article explains how Medicare covers telemedicine.

Why Telehealth is Beneficial to Seniors

Video appointments are quickly becoming a preferred way to monitor senior wellness.

Telehealth visits are beneficial to seniors because, for the less mobile, having a virtual appointment instead of meeting in-office with a health care professional is an easier way to access medical care. Seniors who don’t drive or who have limited mobility do not need to rely on others for transportation when they schedule a telehealth visit. Telehealth reduces strain on caregivers and family members who may otherwise be responsible for taking their loved ones to a traditional appointment, and sometimes it can prevent unnecessary hospital visits and medical bills. 

By participating in telehealth services, seniors, families, and caregivers can:

  • Reduce unnecessary hospital visits
  • Keep the burden of travel and its costs down
  • Reduce stress on caregivers at home

Doctors and other health care providers also benefit from seeing their patients through telehealth. Not only do telehealth visits save time, they also allow the care provider to see how patients are taking care of themselves while at home and identify environmental factors that could cause serious health issues. Care providers can also alert a patient of potential problems that may be developing and encourage an in office visit when needed, or they can put patients’ minds at ease if there are no serious issues to  be found.

While some may assume using digital communication devices like laptops, smartphones, and tablets would be a potential barrier to telehealth for seniors, with some education most seniors can adapt to using this technology with ease.

Medicare Coverage and Telehealth

Traditional Medicare covers some telehealth services. Before 2019 coverage was very limited, and Medicare generally only paid for telehealth services for patients living in designated rural areas who would go to a clinic, hospital, or certain other types of medical facilities to use that facility’s telecommunications systems to speak to a doctor or healthcare provider in another location. Starting in 2020, CMS began expanding telehealth for all seniors, offering coverage for virtual check-ins and e-visits that meet certain conditions, which the beneficiary could receive at home. Coverage is still limited to certain types of care.

During the COVID-19 pandemic in 2020, Original Medicare’s coverage of telehealth services was greatly expanded temporarily. Medicare Part B now allows seniors and other groups of people who are particularly vulnerable to COVID-19 to access more virtual health care services than ever before, including for physical therapy, vision care, and mental health care. While these expansions are only guaranteed to last through 2021 as part of the COVID-19 public health emergency, some of them may remain permanent once the pandemic is over.

What telehealth services are you cover for under Medicare? Call (800) 950-0608 with all your coverage questions, or compare your options with our online quoting tool.

Medicare Advantage and Telehealth

Medicare Advantage is an insurance option available to seniors who are interested in a plan that is different from Original Medicare. Medicare Advantage plans function similarly to a traditional insurance plan with deductibles, copayments, and coinsurance.

Medicare Advantage plans are offered by different private insurance carriers, and must offer all the same benefits as Original Medicare Parts A and B, including telehealth benefits. However, these plans also often offer additional benefits, sometimes including expanded access to virtual care and telehealth. They may be an excellent option for seniors with limited mobility or a frequent need for check-ins and other appointments, because they may provide additional coverage for these services beyond Medicare Part B.

As of May 2020, Medicare Advantage plan subscribers also benefit from the COVID-19 requirements put into place for telehealth by CMS. Seniors can now expect coverage for telehealth visits with doctors and other health professionals in specialties that include:

  • Primary Care
  • Endocrinology
  • Psychiatry
  • Infectious diseases
  • Cardiology
  • Ophthalmology
  • Dermatology

Insurance is a personal decision. Every Medicare Advantage plan is different, and it can be challenging to find the one that best fits your needs and budget. If you need help navigating the health care landscape, call us at (800) 950-0608. We’ll be happy to help you find coverage that meets your expectations.

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